Authorized Use Only

This form is to request reimbursement for expenses that have PRIOR approval from the AZNHA Board either through the budgeting process or specific approval granted through board action. The AZNHA Treasurer is responsible for reviewing and approving Expense Reimbursement requests.

Good to Know
Payment is made by paper check or ACH (you will need to select your preferred method of payment and provide the applicable details).
Receipts are required (the form includes a file upload or you may email your receipts to info@aznha.org).

If you have any questions regarding reimbursement or this form, please contact the Administrator Marie Fredette at info@aznha.org or mobile is 602-692-5315.

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Submitter (Your Name): (Required.)

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Daytime Phone (Required.)

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Total Amount of Reimbursement: (Required.)

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Comments/Questions for the AZNHA Treasurer (Optional):

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